Nokea
The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?
- A. Clopidogrel (Plavix)
- B. Enoxaparin (Lovenox)
- C. Reteplase (Retavase)
- D. Warfarin (Coumadin)
Correct Answer: A
Rationale: The correct answer is A: Clopidogrel (Plavix). Clopidogrel is a platelet inhibitor that helps prevent blood clots by inhibiting platelet aggregation. It is commonly used to reduce the risk of heart attack or stroke. Enoxaparin (Lovenox) is a low molecular weight heparin that works by preventing blood clots by inhibiting clotting factors. Reteplase (Retavase) is a thrombolytic agent used to dissolve blood clots in emergency situations. Warfarin (Coumadin) is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Clopidogrel is the most appropriate choice for a platelet inhibitor in this scenario due to its mechanism of action and indication for preventing blood clots.
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Peripheral bl. Picture is most useful in:
- A. NHL
- B. multiple myeloma
- C. myelodysplastic syndrome
- D. CML
Correct Answer: D
Rationale: The correct answer is D: CML. Peripheral blood picture is most useful in diagnosing CML due to the characteristic presence of increased mature and immature granulocytes, especially neutrophils, in the blood smear. This finding is known as a "left-shift" and is a hallmark of CML. In contrast, NHL (choice A) primarily involves lymphocytes, multiple myeloma (choice B) is characterized by abnormal plasma cells, and myelodysplastic syndrome (choice C) typically presents with dysplastic changes in blood cell precursors. Therefore, based on the specific blood cell findings, CML is the most likely diagnosis when observing a peripheral blood picture.
RBCs break into fragments, they are referred to as schistocytes. These type of cells are seen in
- A. Sickle cell trait
- B. Thalassemia
- C. Microangiopathic hemolytic anemia
- D. Idiopathic thrombocytopenic purpura
Correct Answer: C
Rationale: The correct answer is C, Microangiopathic hemolytic anemia. Schistocytes are fragmented red blood cells caused by mechanical damage as they pass through narrowed vessels. This occurs in conditions like thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, which are types of microangiopathic hemolytic anemia. Sickle cell trait (A) and Thalassemia (B) are genetic disorders affecting red blood cell structure and production, not causing mechanical fragmentation. Idiopathic thrombocytopenic purpura (D) is a disorder characterized by low platelet count, unrelated to RBC fragmentation.
The International Normalized Ratio (INR) was developed for the purpose of
- A. Monitoring heparin therapy
- B. Monitoring oral anticoagulant therapy
- C. Screening for intrinsic clotting system abnormalities
- D. Standardizing the monitoring of warfarin therapy
Correct Answer: D
Rationale: Rationale:
1. INR standardizes PT results across labs.
2. Warfarin therapy requires close monitoring.
3. INR helps adjust warfarin dose accurately.
4. INR is not specific to heparin, oral anticoagulants, or screening for clotting system abnormalities.
Summary:
A: Heparin is monitored by aPTT.
B: Oral anticoagulant therapy is monitored by INR.
C: Intrinsic clotting abnormalities are not detected by INR.
D: Warfarin therapy monitoring is standardized by INR.
A patient who is suspected of having acute viral hemorrhagic fever reveals history of tick bite. Which of the following is the most possible causative agent?
- A. Hantavirus
- B. Rift Valley virus
- C. Crimean Congo virus
- D. Marburg virus
Correct Answer: C
Rationale: The correct answer is C: Crimean Congo virus. This is the most likely causative agent of acute viral hemorrhagic fever following a tick bite due to its association with tick transmission. Crimean Congo virus is a tick-borne virus that causes severe hemorrhagic fever in humans. The other options, Hantavirus, Rift Valley virus, and Marburg virus, are not typically transmitted by ticks. Hantavirus is spread through rodent feces, Rift Valley virus is transmitted by mosquitoes, and Marburg virus is transmitted through direct contact with infected animals or their bodily fluids. Therefore, based on the history of tick bite, Crimean Congo virus is the most probable causative agent.
Plat. Transfusion is not indicated in:
- A. aplastic an.
- B. uraemia with bleeding
- C. DIC
- D. immunogenic thrombocytopenia
Correct Answer: D
Rationale: Plat. transfusion is not indicated in immunogenic thrombocytopenia (ITP) because it is an autoimmune disorder where the body destroys its own platelets. Transfusing platelets won't solve the underlying issue of platelet destruction. In aplastic anemia (A), platelet transfusion can help due to low platelet production. In uremia with bleeding (B) and DIC (C), platelet transfusion is necessary to manage bleeding due to decreased platelet function or consumption.